This course addresses the basics of Medicare Advantage (MA) Plans, a private insurance alternative to Original Medicare that must cover the same baseline benefits as Original Medicare. We’ll see how MA Plans can use networks of providers and service areas, require referrals for specialists, include additional benefits not covered by Original Medicare, and affect a beneficiary’s out-of-pocket costs. You’ll learn about several different types of Medicare Advantage Plan, such as health maintenance organizations and Special Needs Plans, and find out the services that plans must cover and how they may charge different costs or impose different terms than Original Medicare. Finally, we’ll explore beneficiary rights and protections in MA Plans and how these are enforced through grievances and appeals.

After taking this course, you will be able to:

Explain how Medicare Advantage is different from Original Medicare

Identify the main types of Medicare Advantage Plans

Understand the basics of what Medicare Advantage Plans cover, and at what costs

Discuss how and when to file a formal complaint, called a grievance

This course contains the following features:

Interactive activities and knowledge quizzes

Automatic course bookmarking so learners can continue where they left off

Review tests at the end of every course – 80% or higher mark to pass the course and download a certificate of completion

Educational content vetted by a team of national experts at Medicare Rights Center